Gartsman G M, Combs A H, Davis P F, Tullos H S
Baylor College of Medicine, Division of Orthopedic Surgery, Houston, Texas.
Am J Sports Med. 1991 Jan-Feb;19(1):2-5. doi: 10.1177/036354659101900102.
Distal clavicle resection has been an effective procedure for treatment of acromioclavicular arthritis. The conventional open surgical technique involves deltoid detachment and reattachment, which may cause postoperative weakness and requires protection during the postoperative period to allow for healing. Arthroscopic acromioclavicular joint resection has the theoretical advantages of no deltoid disruption and a shorter rehabilitation period. The purpose of this study was to compare open versus arthroscopic acromioclavicular joint resection in a laboratory setting. The goals of acromioclavicular joint resection in this study were to remove 5 mm of the medial acromion and 10 mm of the distal clavicle. Acromioclavicular joint resections were performed on 10 cadaver shoulders (5 open resections and 5 arthroscopic resections). Open resection was successful at 10 of 15 distal clavicle locations and 14 of 15 medial acromial locations. Arthroscopic resection was successful at 14 of 15 distal clavicle locations and 10 of 15 medial acromial locations. The combined bone resection averaged 14.8 mm (+/- 1.99 mm) for the open technique and 14.8 mm (+/- 2.58 mm) for the arthroscopic technique. The combined bone resection was 1.5 cm or more in all of the measured locations for the open technique and in 14 of 15 measure locations for the arthroscopic technique. There was no statistically significant difference between the two groups. In the laboratory setting, acromioclavicular joint resection was performed effectively and predictably with arthroscopic instruments. Arthroscopic bone resection was comparable to open bone resection.
锁骨远端切除术一直是治疗肩锁关节关节炎的有效方法。传统的开放手术技术需要分离和重新附着三角肌，这可能会导致术后肌力减弱，并且在术后需要进行保护以促进愈合。关节镜下肩锁关节切除术理论上具有不破坏三角肌和康复期较短的优点。本研究的目的是在实验室环境中比较开放手术与关节镜下肩锁关节切除术。本研究中肩锁关节切除术的目标是切除内侧肩峰5毫米和锁骨远端10毫米。对10具尸体肩部进行了肩锁关节切除术（5例开放切除术和5例关节镜切除术）。开放切除术在15个锁骨远端位置中的10个以及15个内侧肩峰位置中的14个成功完成。关节镜切除术在15个锁骨远端位置中的14个以及15个内侧肩峰位置中的10个成功完成。开放技术的联合骨切除平均为14.8毫米（±1.99毫米），关节镜技术为14.8毫米（±2.58毫米）。开放技术在所有测量位置的联合骨切除均达到或超过1.5厘米，关节镜技术在15个测量位置中的14个达到此标准。两组之间无统计学显著差异。在实验室环境中，使用关节镜器械可有效且可预测地进行肩锁关节切除术。关节镜下骨切除与开放骨切除效果相当。
